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在续方诊所中重复开药流程的评估及药剂师视角

Evaluation and pharmacists perspective of repeat prescribing process in refill clinics.

作者信息

Alghadeer Sultan, Althunayan Shatha F, Alghamdi Bushra M, Bintaleb Doaa, Alnaim Lamya

机构信息

Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box 2454, Riyadh 11451, Saudi Arabia.

College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.

出版信息

Saudi Pharm J. 2021 Nov;29(11):1336-1342. doi: 10.1016/j.jsps.2021.09.009. Epub 2021 Sep 25.

Abstract

INTRODUCTION

Repeat prescription refers to a re-prescribed medications list issued by a refill clinic, commonly for stable chronic illnesses. The issues regarding repeat prescriptions have garnered increasing important in recent years, as no general agreement about a standardized protocol exists between organizations. Due to the importance of pharmacists' involvement and intervention in the process of repeat prescription and the lack of local studies discussing this topic, the aim of this study was to assess pharmacists' perspectives toward the repeat prescription process and identify the issues related to repeat prescriptions in refill clinics at tertiary hospitals.

METHODOLOGY

A self-developed questionnaire was used to assess outpatient pharmacists' perspectives toward the repeat prescription process. This was followed by a comprehensive review of the electronic health records (EHR) of patients who requested repeat prescriptions to identify related issues. The study was conducted at a tertiary teaching hospital from September 2019 to January 2020.

RESULTS

Based on the questionnaire, 34 pharmacists reported receiving less than 10 repeat prescriptions per week (82.35%); nevertheless, around 88.24% of pharmacists have faced issues with the repeat prescription process, and only 15.65% of the issues got resolved. Most of the pharmacists (88.24%) showed a proactive attitude toward modifying the work process to reduce issues. Further, the review of the patients' EHR identified 1766 prescriptions with related issues in 617 (14.02%) patients' profiles. Most of these issues were seen in the elderly (46.7%). The most common issue encountered was "Patients came too early to request," which accounted for 986 (55.8%) of the total issues, followed by the issue of "Refilling a restricted medication" reported at 247 (14%). Only 11% of these issues were completely resolved by pharmacists.

CONCLUSION

The repeat prescription service might be associated with issues that lead to preventable adverse effects, especially among the elderly who are prone to such effects. Comprehensive reviews of patients' profiles are necessary to assess their needs and avoid such issues.

摘要

引言

重复处方是指由续方诊所开具的重新开具的药物清单,通常用于稳定的慢性病。近年来,与重复处方相关的问题变得越来越重要,因为各组织之间对于标准化协议尚未达成普遍共识。由于药剂师在重复处方过程中的参与和干预至关重要,且缺乏本地关于此主题的研究,本研究的目的是评估药剂师对重复处方过程的看法,并确定三级医院续方诊所中与重复处方相关的问题。

方法

使用自行开发的问卷来评估门诊药剂师对重复处方过程的看法。随后对请求重复处方的患者的电子健康记录(EHR)进行全面审查,以确定相关问题。该研究于2019年9月至2020年1月在一家三级教学医院进行。

结果

根据问卷,34名药剂师报告每周收到少于10份重复处方(82.35%);然而,约88.24%的药剂师在重复处方过程中遇到过问题,且只有15.65%的问题得到解决。大多数药剂师(88.24%)对修改工作流程以减少问题表现出积极态度。此外,对患者EHR的审查在617名(14.02%)患者的病历中发现了1766份有相关问题的处方。这些问题大多出现在老年人中(46.7%)。最常见的问题是“患者来请求续方太早”,占总问题的986例(55.8%),其次是“重新开具受限药物”的问题,报告有247例(14%)。这些问题中只有11%被药剂师完全解决。

结论

重复处方服务可能与导致可预防不良反应的问题相关,尤其是在易受此类影响的老年人中。有必要对患者病历进行全面审查,以评估他们的需求并避免此类问题。

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